AVENUES OF INFECTION 89 



found the portal of entry of microorganisms causing a general infection. 

 The tonsils are well known to be the breeding- and lodging-place of 

 various microparasites causing many general infections, such as acute 

 rheumatic fever, tuberculosis, and possibly typhoid fever. The pharynx 

 may harbor the microorganisms of diphtheria, pneumococcous angina, 

 etc. 



Normally, except for the presence of a few sarcinse, the stomach is 

 practically sterile. Under special conditions, however, typhoid, dysen- 

 tery, cholera, tubercle, and other infectious bacteria may escape the 

 germicidal effects of the hydrochloric acid, and, reaching the alkaline 

 intestinal contents, which are rich in soluble proteins and carbohydrates, 

 are rendered capable of producing their respective infections. 



Although these conditions are primarily of the nature of local in- 

 fection, there is much experimental evidence to show that bacilli, and 

 particularly tubercle bacilli, may pass through a practically intact 

 intestinal wall and find their way to the lymph-glands or to the blood- 

 stream itself. 



Aside from these direct and specific infections, various other micro- 

 organisms, by fermentative action, may alter the intestinal contents 

 and produce toxic products capable of exciting acute and severe toxemias. 

 Some authorities as, e. g., Metchnikoff, regard the various types of colon 

 bacilli as producing toxic products responsible for chronic degenerative 

 lesions of the cardiovascular and other organs. The digestive tract is 

 therefore regarded by some pathologists as a constant menace to health, 

 in that it permits bacteria to enter the lymphatic and blood-streams, or 

 to produce toxic substances detrimental to health and longevity. Adami 

 has drawn particular attention to a condition which he terms subin- 

 fection, and which is dependent upon the constant entrance of colon 

 bacilli into the blood, whence they enter the liver, where their final 

 dissolution takes place, appearing as fine, dumb-bell-like granules 

 inclosed in the cells. 



4. The genital organs are the seat of various local infections that may 

 become wide-spread and general. Normally, the urethra may contain 

 a few cocci which lodge about the meatus; the acid secretions of the 

 vagina are generally inimical to bacterial growth, and the uterus and 

 bladder are usually sterile. But three microorganisms the gonococcus, 

 Treponema pallidum, and the bacillus of Ducrey, here find favorable 

 conditions for growth, and are usually transmitted from person to per- 

 son by means of sexual congress. The local gonococcal lesion may 

 be the portal of entry of gonococci into the blood-stream, resulting in 



